[Effect of oleic acid on the proliferation and secretion of pro-inflammatory mediators of human normal fibroblasts and scar fibroblasts].
To investigate the effect of oleic acid on the proliferation and secretion of pro-inflammatory mediators of human normal fibroblasts and scar fibroblasts. Human normal fibroblasts and scar fibroblasts were cultured in vitro and respectively divided into seven groups according to the random number table, with 8 samples in each group. Cells in blank control (BC) group were routinely cultured without addition of other agents. Cells in ethanol-control (EC) group were cultured with medium with the addition of 2% absolute ethanol. Cells in oleic acid groups were cultured with the addition of oleic acid in concentration of 0.25, 0.50, 1.00, 2.00, or 4.00 mmol/L in 2% absolute ethanol. The growth of cells in each group was observed with trypan blue staining on post culture day (PCD) 1-5. On PCD 2, structure of cells in BC, EC, and 1.00 mmol/L oleic acid groups was observed under inverted phase contrast microscope and transmission electron microscope; cell cycle of BC, EC, and 1.00 mmol/L oleic acid groups was measured by flow cytometer; cell proliferation activity in each group was measured by MTT assay; the level of NO in supernatant was assayed by Griess assay; the levels of TNF-α, IL-1β, IL-6, and IL-8 in supernatants in each group were determined by enzyme-linked immunosorbent assay. Data were processed with multifactor and repeated measurement design analysis of variance. (1) There was no significant difference in each index of normal fibroblasts and scar fibroblasts between BC group and EC group. (2) The numbers of normal fibroblasts and scar fibroblasts in 2.00 and 4.00 mmol/L oleic acid groups were significantly lower than those in corresponding BC and EC groups on PCD 2-5 (with F values respectively 13.773 and 11.344, P values all below 0.01). (3) On PCD 2, the numbers of normal fibroblasts and scar fibroblasts in 1.00 mmol/L oleic acid groups decreased, and the cells were aggregating, rounding, and easy to drop off. Cellular membrane disruption, vacuolar degeneration of mitochondrion, pyknosis, and lipid droplets were observed. (4) The percentages of G0/G1 and G2/M phases of normal fibroblasts in 1.00 mmol/L oleic acid group [(93.56 ± 9.98)%, (2.01 ± 0.75)%] were significantly higher than those in BC group [(84.23 ± 10.96)%, (0.37 ± 0.16)%, with F values respectively 3.026, 34.751, P < 0.05 or P < 0.01], while the percentage of normal fibroblasts in S phase [(4.42 ± 0.87)%] was markedly lower than that in BC group [(16.06 ± 1.74)%, F = 136.120, P < 0.01]. The percentages of scar fibroblasts of G0/G1 and G2/M phases in 1.00 mmol/L oleic acid group [(93.86 ± 13.90)%, (1.89 ± 0.66)%] were significantly higher than those in BC group [(83.88 ± 10.42)%, (0.41 ± 0.17)%, with F values respectively 3.529, 32.710, P < 0.05 or P < 0.01], and the percentage of scar fibroblasts in S phase [(3.87 ± 0.63)%] was markedly lower than that in BC group [(15.89 ± 2.02)%, F = 116.508, P < 0.01]. (5) The proliferation rates of normal fibroblasts and scar fibroblasts in 0.50-4.00 mmol/L oleic acid groups were significantly lower than those in corresponding BC and EC groups (with F values respectively 215.945 and 194.555, P < 0.05 or P < 0.01). (6) The content of NO in supernatant of normal fibroblasts in all oleic acid groups was obviously higher than that in BC and EC groups (F = 30.240, P < 0.05 or P < 0.01). The contents of NO in supernatants of scar fibroblasts in 1.00-4.00 mmol/L oleic acid groups were significantly higher than that in BC and EC groups (F = 12.495, P < 0.01). The contents of TNF-α and IL-6 in supernatants of normal fibroblasts and scar fibroblasts in 2.00 and 4.00 mmol/L oleic acid groups were obviously higher than those in corresponding BC and EC groups (with F(TNF-α) values respectively 6.911, 3.818, F(IL-6) values respectively 16.939, 11.600,P < 0.05 or P < 0.01). The contents of IL-1β in supernatants of normal fibroblasts and scar fibroblasts in groups of every concentration of oleic acid were significantly higher than those in corresponding BC and EC groups (with F values respectively 25.117, 9.137, P values all below 0.01). The contents of IL-8 in supernatants of normal fibroblasts in 1.00-4.00 mmol/L oleic acid groups were markedly higher than those in BC and EC groups (F = 2.717, P < 0.05 or P < 0.01). The contents of IL-8 in supernatants of scar fibroblasts in 2.00 and 4.00 mmol/L oleic acid groups were significantly higher than those in BC and EC groups (F = 3.338, P < 0.05). There was no statistically significant difference in above indexes between normal fibroblasts and scar fibroblasts in the same concentration of oleic acid group (with F values from 0.120 to 3.766, P values all above 0.05). Although oleic acid in high concentration inhibits the proliferation of scar fibroblasts, it also inhibits the proliferation of normal fibroblasts. Oleic acid in high concentration can cause excessive and continued inflammatory reaction by promoting the secretion of pro-inflammatory mediators of normal fibroblasts and scar fibroblasts, and they are detrimental to wound healing.


Successful treatment of kasabach-merritt syndrome with vincristine and surgery: a case report and review of literature.
Haemangiomas are vascular lesions resulting from abnormal proliferation of blood vessels. They are the most common pediatric neoplasm. Kasabach-Merritt syndrome is a rare type of vascular lesion with peculiar characteristics. The diagnosis is based upon three basic findings; enlarging haemangioma, thrombocytopenia and consumption coagulopathy. A 5 month old boy was admitted to the Pediatrics department for the management of an abdominal wall mass. He was the first child of consanguineous parents, born in a private hospital following uncomplicated pregnancy and delivery. At birth a bluish birth mark 5 cm x 5 cm was noted below the umbilicus. Over the next five months, this birth mark increased in size and evolved into a swelling. As a result, the patient was admitted to Maternal and Child Health (MCH) unit for the management of this swelling.The clinical findings and imagining studies followed by laboratory investigations strongly suggested the diagnosis of Kasabach-Merritt syndrome.Vincristine was initiated after a trial of corticosteroids when the platelet count was 6000/cmm. One week after the start of vincristine the size of the lesion started to decrease. At the end of 6th week the lesion size decreased to half and the platelet count increased to 49,000/cmm. Vincristine was continued for another 2 weeks, no further improvement in lesion size or platelet count was observed. Vincristine was discontinued and the patient was shifted to the paediatric surgery department. A fresh platelet transfusion was given and the haemangioma was excised completely.The histopathological examination of the excised mass revealed a caverno-capillary haemangioma with infiltration into skeletal muscles. Six weeks treatment with vincristine in a dose of 0.5 mg/kg/week followed by surgical excision may be the best management in selected cases of Kasabach-Merritt syndrome.


Gate Tunable Organic Light Emitting Diodes: Principles and Prospects.
This record summarizes our recent developments on gate-tunable organic light-emitting diodes (OLEDs). The key point is to modulate the charge carrier injection barrier by the applied gate potential. One way is to electrochemically dope charge carrier injection layer through porous electrodes. The electrochemically doped charge carrier layer thus form gate-tunable contact with porous electrodes. Another way is to modulate the work-function of electrodes that can have varied charge carrier injection barriers following the applied gate potential. Gate-tunable OLEDs based on these two working principles have been fabricated, characterized and demonstrated for displaying simple digitals and letters. New materials including dielectric, porous electrodes, work function tunable electrodes, and charge carrier injection materials have been further explored for performance improvement.


Comparative study on Toxoplasma infection between Malaysian and Myanmar pregnant women.
Toxoplasma gondii, an obligate intracellular protozoan parasite, causes a disease called toxoplasmosis which can sometimes be acquired congenitally by a newborn from an infected mother. This study aimed to determine the seroprevalence of Toxoplasma infection and its associated risks among 219 and 215 pregnant women from Malaysia and Myanmar, respectively. Anti-Toxoplasma IgG and IgM antibodies were screened by using standard commercial ELISA kits. The socio-demographic, obstetrics and risk factors associated with Toxoplasma infection data were compared between the two countries. The overall prevalence of Toxoplasma infection in Malaysian pregnant women (42.47%; 95% CI = 36.11-49.09) was significantly higher (p < 0.05) than Myanmar pregnant women (30.70%; 95% CI = 27.92-37.16). By univariate analysis, this study identified that age group, education, parity, awareness on toxoplasmosis and consumption of undercooked meat were significantly associated (p < 0.05) with Toxoplasma seropositive Malaysian pregnant women but none of these factors associated with Toxoplasma seropositive Myanmar pregnant women. In comparison using univariate analysis between the two countries, it was found that Toxoplasma seropositive Malaysian pregnant women was associated with aged 30 years and above, secondary or lower-secondary level of education, the third trimester of pregnancy, having one child or more, lacking awareness of toxoplasmosis, absence of bad obstetrics history, having no history of close contact with cats or soil, living on a farm and also consumption of undercooked meat, unpasterized milk or untreated water. Avidity measurement was used to confirm the stages of Toxoplasma infection in pregnant women who were positive for both IgG and IgM antibodies and found all were infected in the past. From our study, Toxoplasma screening and its risk measurement in pregnant women is firmly recommended for monitoring purposes and assisting proper management, including diagnosis and treatment during antenatal period. Also, it is necessary to initiate preventive measures for Toxoplasma infection among reproductive-age women in general and seronegative pregnant women in particular. Avidity measurement should be incorporated in Toxoplasma routine screening, especially with the availability of a single serum sample to assist in the diagnosis.


Curcumin and curcumin derivatives inhibit Tat-mediated transactivation of type 1 human immunodeficiency virus long terminal repeat.
The transcription of HIV1 provirus is regulated by both cellular and viral factors. Various evidence suggests that Tat protein secreted by HIV1-infected cells may have additional action in the pathogenesis of AIDS because of its ability to also be taken up by non-infected cells. Curcumin [diferuloylmethane or 1,7-bis-(4-hydroxy-3-methoxyphenyl)-1,6-heptadiene-3,5-dione] is the yellow pigment in turmeric Curcuma longa (Linn). It exhibits a variety of pharmacological effects including antiinflammatory and antiretroviral activities. Here, we demonstrated that curcumin used at 10 to 100 nM inhibited Tat transactivation of HIV1-LTR lacZ by 70 to 80% in HeLa cells. In order to develop more efficient curcumin derivatives, we synthesized and tested in the same experimental system the inhibitory activity of reduced curcumin (C1), which lacks the spatial structure of curcumin; allyl-curcumin (C2), which possesses a condensed allyl derivative on curcumin that plays the role of metal chelator; and tocopheryl-curcumin (C3), which enhances the antioxidant activity of the molecule. Results obtained with C1, C2 and C3 curcumin derivatives showed a significant inhibition (70 to 85%) of Tat transactivation. Despite the fact that tocopheryl-curcumin (C3) failed to scavenge O2.-, this curcumin derivative exhibited the most activity; 70% inhibition was obtained at 1 nM, while only 35% inhibition was obtained with the curcumin.


Production of monoclonal antibodies that detect Hodgkin's high molecular weight transforming growth factor-beta.
High molecular weight transforming growth factor-beta (TGF beta) is a physiologically active TGF secreted by nodular sclerosing Reed-Sternberg cells. Five monoclonal murine antibodies were prepared that distinguished Hodgkin's TGF beta from platelet-derived TGF beta using an enzyme-linked immunosorbent assay, neutralization of biologic activity, and Western blotting. These monoclonal antibodies directed at unique antigenic determinants (epitopes) of Hodgkin's TGF beta will allow further characterization of the role of Hodgkin's TGF beta in Hodgkin's disease and related entities.


Terminal mental illness: resident experience of patient suicide.
Suicide prevention efforts are a major focus of psychiatry residency training. Residents are taught to identify suicide risk factors, monitor for suicidal ideation, and develop crisis stabilization plans for patients at risk for self harm. In contrast, training and support for dealing with suicide completion is often lacking. Although suicide remains a predictable outcome for many patients with severe mental illness, this topic may be avoided or reviewed only with residents who are directly affected by patient suicide. The purpose of this paper is to present a psychiatry resident's experience of dealing with a patient suicide and identify obstacles to developing this aspect of training. Options for "preventative" training in helping trainees deal with this unfortunate outcome of mental illness will be reviewed.


The separation between the 5'-3' ends in long RNA molecules is short and nearly constant.
RNA molecules play different roles in coding, decoding and gene expression regulation. Such roles are often associated to the RNA secondary or tertiary structures. The folding dynamics lead to multiple secondary structures of long RNA molecules, since an RNA molecule might fold into multiple distinct native states. Despite an ensemble of different structures, it has been theoretically proposed that the separation between the 5' and 3' ends of long single-stranded RNA molecules (ssRNA) remains constant, independent of their base content and length. Here, we present the first experimental measurements of the end-to-end separation in long ssRNA molecules. To determine this separation, we use single molecule Fluorescence Resonance Energy Transfer of fluorescently end-labeled ssRNA molecules ranging from 500 to 5500 nucleotides in length, obtained from two viruses and a fungus. We found that the end-to-end separation is indeed short, within 5-9 nm. It is remarkable that the separation of the ends of all RNA molecules studied remains small and similar, despite the origin, length and differences in their secondary structure. This implies that the ssRNA molecules are 'effectively circularized' something that might be a general feature of RNAs, and could result in fine-tuning for translation and gene expression regulation.


Malpractice litigation after total hip arthroplasty: A legal 10-year database.
In this study, we aimed to identify the most frequently reported claims after total hip arthroplasty (THA) and the reasons put forward by the plaintiffs. Between January 2011 and December 2020, data of a total of 74 cases (21 males, 53 females; mean age: 53.7±12.8 years; range, 29 to 83 years) obtained from the Turkish Forensic Medicine Institute were retrospectively analyzed. Claims for litigation, demographic data, data regarding the identity of the accused and the hospital setting were recorded. The most common reason for lawsuits was death (n=15; 20.3%), followed by nerve injury (n=13; 17.6%), and eight patients had more than one complaint. According to the forensic medicine reports, malpractice was detected in 10 (12.5%) of the cases. Among the hospital types, only nerve injury made a significant difference among all complaint sources in different hospital settings (p=0.003). In our study, death was the most common reason for lawsuits regarding malpractice accusations after THA, which is different from medical malpractice allegations throughout the world.


Generation of osteoclasts from type 1 Gaucher patients and correlation with clinical and genetic features of disease.
Gaucher disease (GD) is a rare autosomal recessive disorder caused by deficient activity of β-glucocerebrosidase resulting in the accumulation of glucosylceramide. Bone disease is a common feature with radiological evidence in up to 93% of patients. Severity of bone involvement ranges from osteoporosis to pathological fractures. The progressive course of type 1 GD is largely mitigated by treatment with enzyme replacement therapy (ERT) or substrate reduction. A number of studies have shown some patients suffer bone events while receiving ERT. Studies of biochemical markers of bone turnover have generated varied results and as a consequence are not generally used to assess bone disease in GD. In vitro osteoclast generation from peripheral blood samples of 74 Gaucher patients followed over a period of up to 10 years was correlated with bone events, reports of bone pain, anaemia, spleen status, bone mineral density, chitotriosidase activity, treatment with Gaucher specific therapies, bisphosphonates, mutation status and severity. Osteoclast generation, enumerated when cultured on glass, was significantly higher when differentiated from the peripheral blood of Gaucher patients which reported bone pain (116.4 ± 18.0 vs 69.0 ± 8.6, p < 0.01), had anaemia (153.7 ± 34.9 vs 78.5 ± 8.8, p < 0.01), had a splenectomy (137.6 ± 41.1 vs 60.8 ± 13.0, p < 0.05), versus those who did not. Osteoclast generation was also indicative of in vivo Gaucher specific therapy response as those naïve to therapy generated significantly more osteoclasts than those on therapy (111.2 ± 35.8 vs 45.1 ± 10.3, p < 0.05), as did patients receiving therapy but still suffering bone events (125.1 ± 31.37 vs 45.1 ± 10.33, p < 0.05). These findings demonstrate that the in vitro osteoclast assay may be a useful method for following bone disease progression in Gaucher patients.


Role of Cholesterol and Its Immediate Biosynthetic Precursors in Membrane Dynamics and Heterogeneity: Implications for Health and Disease.
Cholesterol is an indispensible component of cellular membranes in higher eukaryotes and plays a vital role in many cellular functions. 7-Dehydrocholesterol (7-DHC) and desmosterol represent two immediate biosynthetic precursors of cholesterol in the Kandutsch-Russell and Bloch pathways of cholesterol biosynthesis, respectively. Although 7-DHC and desmosterol differ from cholesterol merely by a double bond, accumulation of these two immediate biosynthetic precursors due to defective cholesterol biosynthesis leads to severe developmental and neurological disorders. In this context, we explored the role of cholesterol and its immediate biosynthetic precursors (7-DHC and desmosterol) on the dynamics and heterogeneity of fluid phase POPC (1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine) and gel phase DPPC (1,2-dipalmitoyl-sn-glycero-3-phosphocholine) membranes, using fluorescence lifetime distribution analysis of Nile Red (9-diethylamino-5H-benzo[α]phenoxazine-5-one) using the maximum entropy method (MEM). We show here that the membrane interfacial dynamic heterogeneity, manifested as the width of the fluorescence lifetime distribution of Nile Red, exhibited by 7-DHC and desmosterol vastly differ from that displayed by cholesterol, particularly in fluid phase membranes. We conclude that a subtle alteration in sterol structure could considerably alter dynamic membrane heterogeneity, which could have implications in pathogenicity associated with defective cholesterol biosynthesis.


Selective trapping of labile S3 in a porous coordination network and the direct X-ray observation.
S3 is one of the basic allotropes of sulfur but is still a mysterious labile species. We selectively trapped S3 in a pore of a thermally stable coordination network and determined S3 structure by ab initio X-ray powder diffraction analysis. S3 in a pore has a C2v bent structure. The network containing trapped S3 is remarkably stable under ambient conditions and is inert to photoirradiation. S3 in the network could be transformed to S6 by mechanical grinding or heating in the presence of NH4X (X = Cl or Br). S6 could be reverse-transformed to S3 by photoirradiation. We also determined the structure of the network containing S6 by ab initio X-ray powder diffraction analysis.


PROSPECTIVE OBSERVATIONAL COHORT STUDY OF PREDICTORS OF THE EFFECTIVENESS OF PEGYLATED INTERFERON IN PATIENTS WITH HEPATITIS C IN GEORGIA.
The main objective of the study was to evaluate the predictive values of virological response at 4th and 12th weeks after treatment initiation on sustained virological response by HCV genotype in patients with hepatitis C in Georgia. Local, non-interventional, prospective, cohort study was conducted in 2011-2016. A cohort of adult peginterferon treatment naïve patients with chronic hepatitis C were observed during the complete active treatment period with PEGASYS®/COPEGUS® and 24 weeks after the end of treatment. HCV RNA titers were assessed prior to treatment, after 4, 12 weeks of treatment, at the end of treatment and 24 weeks after the end of treatment.530 men and women aged ≥18 years with serologically proven CHC (all genotypes) were enrolled in this study. Enrolles study subjects were treated with PEGASYS® 180mkg (peginterferon alfa-2a) in combination with COPEGUS® 200mg (ribavirin) according to the current standard of care and in line with current summary of product characteristics. All clinical information for this cohort study was collected from the patient's medical records. All laboratory parameters which were collected for this observational study according to the protocol were performed in study centers. All data were analyzed with descriptive and analytical statistics. Our analysis demonstrated that the early achievement of viral response predicts the higher probability of achieving sustainvirul response. The viral response itself was strongly associated with baseline liver fibrosis quantitive HCV RNA level. Early starting of treatment determines the probability of achievement higher osustain viral response.


Erythromelalgia involving the face.
Erythromelalgia is a rare disorder characterized by burning pain, erythema, and increased temperature typically involving the distal extremities. Although it can progress to involve the face, erythromelalgia presenting only on the face is particularly rare. This disorder is often misdiagnosed when it presents on the extremities and is even more likely to be misdiagnosed when presenting only on the face, delaying appropriate treatment and causing considerable frustration for the patient. We report a case of a 26-year-old woman with erythromelalgia that involved only the face for a number of years and was treated unsuccessfully as rosacea, seborrheic dermatitis, and contact dermatitis. She subsequently developed involvement of the ears and hands in the more typical distribution of erythromelalgia. We discuss the differential diagnosis of erythromelalgia involving the face and extremities, the proposed pathogenesis and management of the disorder, and the psychological distress this condition can cause. Even when the correct diagnosis of erythromelalgiais made, treatment is difficult, with no single therapy consistently effective.


Cytomegalovirus retinitis as the initial manifestation of the acquired immune deficiency syndrome.
We studied eight patients in whom cytomegalovirus retinitis was an initial manifestation of AIDS. Six of these patients had cytomegalovirus retinitis alone at the time of diagnosis and two patients had simultaneous cytomegalovirus retinitis with other AIDS associated diseases (Kaposi's sarcoma in one patient and cytomegalovirus colitis in one patient). Treatment with ganciclovir (dihydroxy propoxymethyl guanine), a new antiviral medication related to acyclovir, resulted in regression of retinitis in all five patients treated with this drug. Our study shows that cytomegalovirus retinitis may be the initial manifestation of AIDS and that ganciclovir is a clinically effective antiviral agent for cytomegalovirus.


Comparative study of the locked intramedullary nail and Ender pins in the treatment of tibial diaphyseal fractures.
To compare the locked, unreamed intramedullary nail with Ender pins in the treatment of open Gustilo grade I or II or closed tibial diaphyseal fractures of type A, B, or C2 of the AO classification. Forty-four patients with unilateral tibial diaphyseal fractures were treated with intramedullary nails or Ender pins. Twenty patients were treated with an unreamed intramedullary nail with access via the patellar tendon with static locking. Twenty-four patients were treated with Ender pins introduced medially and laterally with respect to the tuberosity of the tibia. The main parameters analyzed were type of reduction, complications, union rate, deformities, joint mobility, pain, gait, effort capacity, presence of neurovascular disorders, and complaints related to the synthesis material. During 1 year of follow-up, the fractures of 90.0% of the patients with intramedullary nails and 95.7% of patients with Ender pins healed within an average of 21.5 weeks and 20.9 weeks, respectively. The significant findings were as follows: patients treated with Ender pins had less mobility of the subtalar joint; patients treated with intramedullary nails were more likely to have pain in the knee; both groups showed shortening of the tibia at the end of 1 year of treatment. The two methods are similar in the treatment of type A, B, and C2 tibial diaphyseal fractures.


Case Report: Postpartum Cough and Dyspnea.
Peripartum/postpartum cardiomyopathy (PPCM) is a rare condition associated with pregnancy in which there is left ventricular (LV) dysfunction resulting in symptoms of heart failure (). This occurs in previously healthy women and is seen in the last month of pregnancy or during the first 5 months postpartum (). Incidence ranges from 1 in 1,300 to 1 in 15,000 pregnancies in the United States (). A case study is presented of a patient with severe impairment of LV function seen in the emergency department (ED). The ED is a common location for initial presentation; therefore, the ED provider should be cognizant of key features of PPCM. The differential diagnosis and medical management of PPCM are discussed. Emergency department management should focus on 3 key elements: an increase in inotropy and a reduction in preload and afterload. Differences between postpartum and peripartum states are outlined.


Fecal Occult Blood Tests in Colorectal Cancer Screening: Systematic Review and Meta-analysis of Traditional and New-generation Fecal Immunochemical Tests.
Noninvasive fecal occult blood tests (FOBTs) are recommended by current guidelines for colorectal cancer (CRC) screening. Our aim was to assess the diagnostic performance of traditional guaiac-based FOBTs (gFOBT) and new-generation immunochemical FOBTs (iFOBT) in CRC screening by carrying out a systematic review and meta-analysis. PubMed, Embase, Cochrane Library, and Web of Science were searched for eligible articles published before February 17, 2020. Three independent investigators conducted study assessment and data extraction. Diagnosis-related indicators for use of FOBTs in the detection of CRC (as the endpoint) in a screening setting were summarized, and further stratified by the type of FOBT (gFOBT vs. iFOBT). STATA software was used to conduct the meta-analysis. Pooled sensitivities and specificities were calculated using a random-effects model. Hierarchical summary receiver operating characteristic curves were plotted and area under the curves (AUC) were calculated. The electronic search identified 573 records after duplicates were removed, of which 75 full-text articles were assessed for eligibility. Finally, a total of 31 studies were eligible for the meta-analysis. In the ROC comparison test, there was a statistically significant difference in the performance of gFOBT and iFOBT tests, with AUC=0.77 (95% confidence intervaI=0.75-0.79) and AUC=0.87 (95% confidence intervaI=0.85-0.88), respectively (p=0.0017). In formal meta-regression, test brand did not prove to be a significant study-level covariate that would explain the observed heterogeneity between the studies. New-generation iFOBTs were found to have a significantly higher diagnostic performance as compared with gFOBTs, advocating the use of only fecal immunochemical tests in all newly implemented CRC screening programs.


Effect of supplemented sericin on the development, cell number, cryosurvival and number of lipid droplets in cultured bovine embryos.
Sericin was investigated as an alternative to fetal bovine serum (FBS) for bovine embryo culture. In vitro matured oocytes were developed using 0.05%, 0.1% or 0.15% sericin. The developmental rate, cryosurvival rate and blastulation time of these embryos were compared with those of embryos developed using 5% FBS. The number of lipid droplets was compared among the blastocysts developed using 5% FBS, using 0.05% sericin and in vivo. The rate of cleavage and blastocyst formation was similar among all groups. Blastulation occurred significantly earlier in the embryos developed using 5% FBS than in those developed using sericin at any concentration (P < 0.05). At 72 h after thawing, the cryosurvival rate of the blastocysts developed using 5% FBS and 0.05% sericin were significantly higher compared with those developed using 0.1% and 0.15% sericin (P < 0.05). The blastocysts developed using 0.05% sericin and in vivo produced a significantly fewer number of medium and large lipid droplets than those developed using 5% FBS. These results suggest that the blastocysts developed using 0.05% sericin show characteristics similar to those of the blastocysts developed in vivo and that the use of sericin as an alternative to FBS is feasible.


Self-Reported Lifetime Violence Exposure and Self-Compassion Associated With Satisfaction of Life in Historically Black College and University Students.
In the United States, approximately 25% of minors have witnessed a violent act, specifically physical assault. African Americans from under-served backgrounds are more likely than other racial and ethnic groups to be exposed to traumatic events. However, there is scant literature examining violence exposure, SC, and life satisfaction collectively, specifically in an African American college sample. The current study sought to determine the associations among violence exposure, SC components, and life satisfaction in an African American college sample. The current sample was comprised of 356 participants (80% female) with a mean age of 20.23 (SD = 1.70). Eighty-eight participants (25%) reported being exposed to violence in their lifetime. Employing logistic regression, we determined violence exposed individuals were less likely to report high satisfaction of life than their non-exposed counterparts (OR = 0.58, 95% CIs = 0.33, 1.00). Individuals with high level of self-kindness were approximately two times more likely to have higher satisfaction of life (OR = 2.48; CI = 1.52, 4.05) compared to their low level self-kindness counterparts and in the presence of demographic covariates. These findings may educate and increase awareness of the impacts of traumatic events. This education could lead to the implementation of interventions to build upon overall well-being in order increase life satisfaction in college students.


Protective effect of baicalin on fetal lung development in a rabbit model of congenital diaphragmatic hernia.
Bacalin has been reported to improve fetal lung growth by increasing fetal lung surfactant phospholipids. Therefore, the present study evaluated the effect of transplacental treatment of baicalin during lung development in rabbits with congenital diaphragmatic hernia (DH) rabbit. DH was induced in fetal rabbit on gestational day 23 and baicalin injections were administered daily until term period. Fetal survival rate, body weight and lung-to-body weight ratio (LBWR) were subsequently measured, and the expression of surfactant protein B (SPB) and Ki-67, and morphometry analysis was determined in lung tissues. It was observed that in baicalin treated group the fetal survival rate and LBWR were decreased compared with the control without DH group. Lung morphometry results suggested that treatment with baicalin did not significantly ameliorate congenital DH, and adventitial and medial thickness were similar to those in the control groups, and less muscularization of vessels measuring 30-60 µm. Furthermore, baicalin treatment did not markedly affect the expressions of Ki-67 and SPB in fetuses with DH. Baicalin was demonstrated to improve the morphology of lung in rabbits; however, as it did not induce marked airway changes this present study suggests that baicalin is not suitable for the management of congenital DH.


An Exploration of the Heterogeneous Nature of Reading Comprehension Development in First Grade: The Impact of Word and Meaning Skills.
This exploratory study builds upon extant reading development studies by identifying discrete groups based on reading comprehension trajectories across first grade. The main goal of this study was to enhance the field's understanding of early reading comprehension development and its underlying subcomponent skills, with the intent of better understanding the development of comprehension in students who display risk for reading difficulties and disabilities. A sample of first-grade readers (N = 314) were assessed at three timepoints across the first-grade year. These data were utilized to derive empirical latent classes based on reading comprehension performance across the first-grade year. Reading subcomponent skill assessments (phonological awareness, word reading, decoding, linguistic comprehension, and reading fluency), measured in the fall of first grade, were compared across latent classes to examine how they related to growth across the first-grade year. Results suggest that there were four distinct latent classes with differential reading comprehension development, each of which could also be distinguished by the subskill assessments. These findings are presented within the context of the broader reading research base, and implications for practice are discussed.


Body Image, Attractiveness, and Sexual Satisfaction Among Midlife Women: A Qualitative Study.
Women often undergo physical changes during the menopause transition, but the relationship between body image and sexual function in midlife is unclear. We used a qualitative approach to explore how body image relates to sexual function and satisfaction in midlife women. We conducted 19 individual interviews and 3 focus groups (total N = 39) among sexually active women 45-60 years of age using a semistructured guide. Sessions were audiorecorded and transcribed. Two investigators developed a codebook using an iterative process; the primary investigator then coded all data. Codes relating to body image were examined to identify key themes. The mean age was 58 (range 46-59); 54% were White, 36% Black, and 10% were of another race. Most (72%) were peri- or postmenopausal. All but two women identified as heterosexual. Feeling attractive was an important reason for sexual activity. Changes in appearance, especially weight gain and breast changes, were common among these women. Women's body image impacted their sexual satisfaction; women who felt self-conscious about their bodies reported that these concerns had a negative impact on their sexual satisfaction, whereas women who felt confident discussed better sexual satisfaction, even in the face of bodily changes. Black women were more likely to discuss feeling confident than White women. Feeling attractive is important to sexual satisfaction in midlife women. Bodily changes, especially weight gain, are common during midlife. While many women are self-conscious about their appearance, some women develop increased self-acceptance. Supporting positive body image may help midlife women maintain sexual satisfaction with aging.


Antiretroviral adherence during pregnancy and postpartum in Latin America.
Adherence to antiretrovirals by pregnant women (and postpartum women if breastfeeding) is crucial to effectively decrease maternal viral load and decrease the risk of mother-to-child transmission of HIV. Our objectives were to describe self-reported adherence to antiretrovirals during the antepartum (after 22 weeks of pregnancy) and postpartum periods (6-12 weeks and 6 months), and identify predictors of adherence among HIV-infected women enrolled and followed in a prospective cohort study from June 2008 to June 2010 at multiple sites in Latin America. Adherence was evaluated using the number of missed and expected doses during the 3 days before the study visit. At the pre-delivery visit, 340 of 376 women (90%) reported perfect adherence. This rate significantly decreased by 6-12 weeks (171/214 [80%]) and 6 months postpartum (163/199 [82%], p<0.01). The odds for less than perfect adherence at the pre-delivery visit was significantly higher for pregnant women with current tobacco use (odds ratio [OR]=2.9, 95% confidence interval [CI]: 1.46-6.14; p=0.0029). At 6-12 weeks postpartum, the probability of non-perfect adherence increased by 6% for each 1 year increase in age (OR=1.06, 95% CI: 1.00-1.12, p=0.0497). At 6 months postpartum, the odds of nonperfect adherence was higher for those who were currently using alcohol (OR=3.04, 95% CI: 1.34-6.90; p=0.0079). Although a self-report measure of adherence based on only 3 days may lead to overestimation of actual adherence over time, women with perfect adherence had lower viral loads and higher CD4 counts. Adherence to antiretrovirals decreased significantly postpartum. Interventions should target women at high risk for lower adherence during pregnancy and postpartum, including tobacco and alcohol users.


[Therapy for Graves' ophthalmopathy].
Graves' ophthalmopathy (GO) is also called thyroid-related eye disease, infiltrative ophthalmopathy, which is related with the autoimmunity of thyroid, especially hyperthyroidism. Its morbidity ragnes from five percent to ten percent of hyperthyroidism, and the morbidity of male patients is higher than that of the female patients. The treatment of severe GO is a difficult task for doctors. The therapeutic effect is not always satisfactory. In order to solve this knotty problem, researchers have been devoting themselves to the development of new therapeutic methods. Here, the development of the therapies for GO is introduced, and the trends of treatments are prospected.


Multiple mechanisms of B cell immunoregulation in man after administration of in vivo corticosteroids.
Despite the extensive clinical use of corticosteroids (CS) in the treatment of immune-mediated diseases, relatively little is known concerning the effects of CS on B cell function as measured by in vitro assays. The effects of single-dose vs several days of in vivo CS therapy on the spontaneous and mitogen-induced Ig production by human peripheral blood B cells are reported here. Spontaneous Ig production by individual B cells was enhanced by in vivo CS as measured by an in vitro plaque-forming cell (PFC) assay. The same increased response was also observed with a brief in vitro exposure of the B cells to CS, which suggests that a mere brief exposure to an active CS analogue is all that is required to produce the enhanced response. The immunoregulatory effects of in vivo CS on mitogen-induced Ig production are more complex. Pokeweed mitogen-induced PFC responses were suppressed 4 to 5 hr after a single in vivo pharmacologic dose of CS, with complete recovery by 24 hr. In contrast, after a 5-day course of CS, the suppressed PFC response did not recover until 60 hr after the last dose. Moreover, several mechanisms of suppression were operative. Ten hours after completing the 5-day course of CS, there was a relative enrichment in the peripheral blood compartment of lymphocytes bearing the OKT8 suppressor/cytotoxic T cell phenotype that coincided with a depressed PFC response. At 36 hr after the last dose, the T lymphocyte profile returned to normal while B cell function remained suppressed. The complex, multifaceted modulation of the immune response, resulting from redistribution of cell subsets as well as altered cell functions, vary with time-dose parameters of in vivo CS administration. These observations should provide additional insights into the heterogeneity of CS-induced therapeutic effects.


Could bradykinesia in Parkinson's disease simply be compensation?
Even normal movements can be slow and hesitant. To distinguish between bradykinesia and the simple slow inefficiency sometimes seen in normal movement, we matched the movement durations of 12 patients with Parkinson's disease (PD) and 12 age-matched controls and examined end-point accuracy, number of submovements, force inefficiency, and relative duration of acceleration and deceleration phases of movement. Subjects used an electronic pen which sampled pen-tip position at 200 Hz, and performed a sequence of drawing movements to nine targets (0.5, 1, or 2 cm diameter) upon a WACOM SD420 graphics tablet. Patients could be trained to move at the preferred speed of controls (and vice versa). When moving at the same fast speed as controls, patient's movements were less accurate (increased end-point spread). Even when moving at their own preferred speed, patients' movements were less efficient (more submovements, more zero crossings in acceleration function) than controls moving at the same speed. If bradykinesia simply reflected increased caution and visual guidance, we would expect patients to exhibit prolonged decelerative phases of movement associated with terminal guidance. However, patients consistently required prolonged accelerative phases of movement, suggesting that there was a problem in generating appropriate movement forces to produce the required end-point accuracy. It is hypothesised that bradykinesia is not simply a compensation for defective preparatory processes, but may reflect a defective internal cue in PD which disrupts and impairs the outflow of motor responses.


Single Quantum Dot Tracking Unravels Agonist Effects on the Dopamine Receptor Dynamics.
D2 dopamine receptors (DRD2s) belong to a family of G protein-coupled receptors that modulate synaptic dopaminergic tone via regulation of dopamine synthesis, storage, and synaptic release. DRD2s are the primary target for traditional antipsychotic medications; dysfunctional DRD2 signaling has been linked to major depressive disorder, attention-deficit hyperactivity disorder, addiction, Parkinson's, and schizophrenia. DRD2 lateral diffusion appears to be an important post-translational regulatory mechanism; however, the dynamic response of DRD2s to ligand-induced activation is poorly understood. Dynamic imaging of the long isoform of DRD2 (D2L) fused to an N-terminal antihemagglutinin (HA) epitope and transiently expressed in HEK-293 cells was achieved through a combination of a high-affinity biotinylated anti-HA antigen-binding fragment (Fab) and streptavidin-conjugated quantum dots (QD). Significant reduction (∼40%) in the rate of lateral diffusion of QD-tagged D2L proteins was observed under agonist (quinpirole; QN)-stimulated conditions compared to basal conditions. QN-induced diffusional slowing was accompanied by an increase in frequency, lifetime, and confinement of temporary arrest of lateral diffusion (TALL), an intrinsic property of single receptor lateral motion. The role of the actin cytoskeleton in QN-induced diffusional slowing of D2L was also explored. The observed dynamic changes appear to be a sensitive indicator of the receptor activity status and might also spatially and temporally shape the receptor-mediated downstream signaling. This dynamic information could potentially be useful in informing drug discovery efforts based on single-molecule pharmacology.


Acute myocardial infarction caused by filgrastim: a case report.
Common uses of the granulocyte-colony stimulating factors in the clinical practice raise the concern about side effects of these agents. We presented a case report about an acute myocardial infarction with non-ST segment elevation during filgrastim administration. A 73-year-old man had squamous cell carcinoma of larynx with lung metastasis treated with the chemotherapy. Second day after the filgrastim, patient had a chest discomfort. An ECG was performed and showed an ST segment depression and negative T waves on inferior derivations. A coronary angiography had showed a critical lesion in right coronary arteria. This is the first study thats revealed that G-CSF can cause acute myocardial infarction in cancer patients without history of cardiac disease. Patients with chest discomfort and pain who are on treatment with G-CSF or GM-CSF must alert the physicians for acute coronary events.


Obesity: the science behind the management.
The prevalence of obesity is increasing in Western and Westernizing countries. The changing environment plays a major role in this increase, particularly the reduction in physical activity. There is also a strong genetic contribution to the development of obesity, although single-gene defect obesity is rare. Neither the environment nor genes is simple to modify. Obesity is an energy-balance disorder, and the human body has evolved to resist any loss of body fat. This biological drive to maintain weight is coordinated through central pathways, with the involvement of many neuropeptides. Thus, dietary restriction will induce changes designed to counter weight loss, including a fall in resting metabolic rate. The management of obesity demands reasonable goals, which focus on metabolic, rather than cosmetic, improvement. As obesity is a complex condition, multiple therapeutic strategies are required. Dietary modification, an increase in physical activity, a reduction in sedentary activity and behaviour modification all form the basis of obesity therapy. Drug therapy options at present are limited and may have a stronger role in weight maintenance. Currently, surgical management of obesity has the best long-term outcomes. Long-term maintenance of weight loss is achieved by few individuals. Those individuals who are successful are able to maintain long-term restrictive eating habits and high levels of physical activity.


Application of fluorescent in situ hybridization (FISH) for the detection of Helicobacter pylori.
Peptic ulceration following infection of the stomach with H. Pylori is a common disease. Accurate and rapid detection of the bacteria can lead to the implementation of appropriate treatment and recovery. Chronic infection of the gastric milieu with H. Pylori may lead to gastric carcinoma. Routine detection of this bacterium in peptic ulcer is based on the urease test and culture of peptic biopsies. Unfortunately, the sensitivity and specificity of both tests are not satisfying. Molecular techniques have been successfully applied for the rapid and accurate detection of bacterial agents in clinical samples. This study was undertaken to evaluate the sensitivity and specificity of fluorescent in situ hybridization (FISH) in the detection of H. Pylori in patients suffering from dyspepsia. One hundred gastric biopsy samples taken by endoscopy from the antrum and corpus of the stomach were tested by FISH and compared with the conventional culture method complemented by biochemical tests. FISH detected H. Pylori in 48 clinical samples, while the conventional method detected 42 samples. The sensitivity and specificity of FISH for the detection of H. Pylori were calculated as 98% and 100%, respectively. The findings of this study suggest that FISH is a highly suitable and rapid method for diagnosing H. Pylori. Especially when the samples are taken from the antrum and the corpus of the stomach, this technique potentially can be applied routinely for the detection of this bacterium in clinical samples.


Risk Factors and Optimal Methods for Incisional Hernias After Kidney Transplantation: A Single-Center Experience From Asia.
For kidney transplant patients, incisional hernia (IH) is a major complication resulting from prolonged pretransplant dialysis, immunosuppressive drugs, and the high prevalence of diabetes. However, there have been relatively few studies of IH after kidney transplantation (KT) in Japan and in the greater Asian population. Additionally, operative methods for IH repair have not been established. We retrospectively analyzed 465 consecutive patients who underwent KT at our hospital from April 2013 to March 2019. Patients who underwent incisional hernia repair were included in this study, and the follow-up time was extended to September 2020. We defined severe IH as an IH requiring surgical repair. We examine the risk factors for severe IH among KT patients and also discuss the operative methods of IH repair. During the study period, 7 patients developed severe IH after KT. The cumulative occurrence rate for severe IH was 1.1% 1 year postoperatively. Multivariate logistic regression analyses showed that age at KT and dialysis duration (hazard ratio = 1.112, P = .016; hazard ratio = 1.106, respectively; P = .038) were independent risk factors for severe IH. We used polypropylene mesh for IH repair in all cases, with onlay repair performed in 5 of 7 cases. There was no recurrence or infection after mesh repair during follow-up. In this study, age at KT and dialysis duration were independent risk factors for severe IH in the Japanese population. Onlay repair with a polypropylene mesh appeared to be a safe and acceptable operation for IH repair after KT.


Pneumococcal and Meningococcal Vaccination among Michigan Children with Sickle Cell Disease.
To determine the proportion of Michigan children with sickle cell disease (SCD) who were vaccinated according to pneumococcal vaccination recommendations and, secondarily, to examine uptake of meningococcal vaccine, and to compare up-to-date (UTD) vaccination status between children with and without SCD. Children with SCD who were born in Michigan were matched to controls without SCD using age, sex, race, and zip code. Using data from the state immunization registry, we assessed the significance of SCD status on UTD vaccination in logistic regression models. By 36 months, substantially more children with SCD had completed the pneumococcal conjugate vaccine series (68.8%) than children without SCD (45.2%), and 59% of children with SCD had received a meningococcal vaccine. Compared with children without SCD, children with SCD had higher odds of UTD pneumococcal status at 5, 7, and 16 months. However, a large proportion of children with SCD were missing key vaccination targets: of those who received a full 7-valent pneumococcal conjugate vaccine series, 29.1% had not received a 13-valent pneumococcal conjugate vaccine dose, and 21.8% had not had pneumococcal polysaccharide vaccine administered. The pneumococcal and meningococcal vaccination schedules have become increasingly complex in recent years. Assessment algorithms programmed to forecast doses due based on high-risk conditions, such as SCD, could provide a useful reminder to healthcare providers in the context of increasingly complex and changing recommendations.


Numerical assessments of recharge-dominated groundwater flow and transport in the nearshore reclamation area in western Taiwan.
This study employed experimental and numerical methods to assess the behavior of conservative solute transport for a selected temporary solid waste site in a reclamation area in western Taiwan. Calibrating a site-specific numerical model, finite element model of water flow through saturated-unsaturated media (FEMWATER), relies on observations from field- and laboratory-scale hydraulic tests and spatial-temporal monitoring. The field-scale experiment used a modified hydraulic tomography survey (MHTS) to identify near surface aquifer stratifications and estimate the distribution of saturated hydraulic conductivity. The pressure plate experiments provided parameters for the van Genuchten soil characteristic model. Sensitivity analyses were then conducted based on varied recharge rates and dispersivities applied to the calibrated model. Observations of groundwater levels and salinity in the wells indicated that the regional groundwater flow was from southeast to northwest. In addition, a shallow freshwater layer was noted in the study area. The tidal-induced amplitudes for water level fluctuation in the wells ranged from 2 to 20 cm, depending on their distance from the seawater body. MHTS showed clear stratification, similar to that of well loggings at the storage site. The hydraulic conductivity at the test site ranged from 8 to 10 m/day, which is close to that obtained from the laboratory falling head test. The results of particle-tracking modeling showed that the critical recharge rate for the site needed to enhance plume traveling is 1000 mm/year. The increase in dispersivity values induced a decrease in plume travel time of up to 1000 days from the site to the coastal line. A special case for pulse releasing solute at the site shows that the key factor in controlling plume migration is the recharge rate. This is due to the low natural head gradient in the reclamation area. The results therefore suggest that a land drainage system near the site can play an important role in contaminant transport in the reclamation area.


Associations between long-term blood pressure trajectory and all-cause and CVD mortality among old people in China.
Optimal blood pressure (BP) management strategy among the elderly remains controversial, with insufficient consideration of long-term BP trajectory. This study aimed to identify BP trajectory patterns as well as terminal BP trajectory among the Chinese elderly and to explore the relationships between BP trajectories and all-cause mortality and cardiovascular disease (CVD) mortality. We included 11,181 participants older than 60 at baseline (mean age, 80.98 ± 10.71) with 42,871 routine BP measurements from the Chinese Longitudinal Healthy Longevity Survey. Latent class trajectory analysis and Cox proportional hazard model were conducted to identify trajectory patterns and their associations with mortality. Furthermore, we also applied mixed-effects model to identify terminal BP trajectories among the elderly. Compared with stable at normal high level trajectory, excess systolic BP (SBP) trajectory with decreasing trend was associated with a 34% (HR = 1.34, 95% CI: 1.23-1.45) higher risk of all-cause mortality. Considering the competing risk of non-CVD death, excess BP trajectory with decreasing trend had a more pronounced effect on CVD mortality, in which HR (95% CI) was 1.67 (1.17, 2.37). Similar results were also found in diastolic BP (DBP), pulse pressure (PP), and mean arterial pressure (MAP) trajectories. We further conducted a mixed-effects model and observed that SBP and PP trajectories first increased and began to decline slightly six years before death. In contrast, DBP and MAP showed continuous decline 15 years before death. Long-term BP trajectory was associated with all-cause mortality, especially CVD mortality. Keeping a stable BP over time may be an important way for CVD prevention among the elderly.


[Evaluation of autonomic function using posture change].
There are several examinations to evaluate cardiac autonomic function. Autonomic neuropathy is a common complication of diabetes mellitus and is associated with increased mortality. Baroreflex sensitivity (BRS) is a marker for the ability to augment vagal activity. Several studies have shown that BRS is impaired in diabetes with autonomic neuropathy. The head-up tilt test is the most useful tool to diagnose the neurally mediated syncope. We have developed a new non-invasive method to evaluate the baroreflex using downward tilting (DT-BRS). In our previous study conducted in healthy volunteers and diabetic patients, we demonstrated a strong correlation between systolic blood pressure increase and corresponding RR interval lengthening during downward tilting, which yielded DT-BRS values that correlated well with the BRS value obtained by the phenylephrine method (Phe-BRS). Heart rate responses observed after both squatting and standing (squatting test) are assumed to be a simple and useful tool to assess autonomic activity. We reported that indices of the squatting test showed a significant correlation with BRS assessed by Phe-BRS in diabetes. DT-BRS and the squatting test may provide promising information for the assessment of reflex vagal activity in diabetes.


[Suicide under the influence of "magic mushrooms"].
Psilocybin/psilocin from so-called psychoactive mushrooms causes hallucinogenic effects. Especially for people with mental or psychiatric disorders ingestion of magic mushrooms may result in horror trips combined with the intention of self-destruction and suicidal thoughts. Automutilation after consumption of hallucinogenic mushrooms has already been described. Our case report demonstrates the suicide of a man by self-inflicted cut and stab injuries. A causal connection between suicidal behaviour and previous ingestion of psychoactive mushrooms is discussed.


Association between extremely high-density lipoprotein cholesterol and adverse cardiovascular outcomes: a systematic review and meta-analysis.
The association between high-density lipoprotein cholesterol (HDL-C) and adverse cardiovascular outcomes is understudied. Based on cohort studies, the current study aimed to investigate the association of extremely high HDL-C with all-cause, atherosclerotic cardiovascular disease (CVD) mortality, and stroke risk. A systematic literature search in Embase, PubMed, Cochrane Library, and Web of Science was performed to collect relevant cohort studies published before August 20, 2022. A random-effects model was used to pool relative risks (RRs) and 95% confidence intervals (CIs). A total of 17 cohort studies involving 19,630,829 participants were included, encompassing 18,547,132 total deaths (1,328,036 CVD deaths). All-cause mortality, CVD mortality, and stroke risk in the extremely high HDL-C group were increased by 15% (RR = 1.15, 95% CI:1.05-1.25), 14% (RR = 1.14, 95% CI:0.96-1.35) and 14% (RR = 1.14, 95% CI:0.82-1.58), compared to the normal HDL-C group. In subgroup analyses, extremely high HDL-C was associated with a reduced risk of CVD mortality in women and a lower risk of stroke in men compared to normal HDL-C levels. The extremely high levels of HDL-C were associated with elevated risks of all-cause mortality, CVD mortality, and stroke. More well-designed studies are needed to confirm our findings. https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=370201, identifier: CRD42022370201.


Biological variation of metabolic cardiovascular risk factors in haemodialysis patients and healthy individuals.
Maintenance haemodialysis (HD) is associated with a very high cardiovascular risk and the assessment of metabolic cardiovascular risk factors is essential for an adequate diagnosis and management. The aim of the study has been to estimate the biological variation (BV) of serum lipids, calcium, inorganic phosphorus, 25-OH vitamin D, C-reactive protein and plasma intact parathyroid hormone (PTHi) and total homocysteine, to evaluate whether HD alter the homeostatic set-point of these magnitudes. Blood samples were collected from 18 HD patients in steady-state conditions, one per month during 6 months, and from 11 healthy volunteers at weekly intervals over 5 weeks. BV data were derived using CV-ANOVA. Within-subject coefficients of variation (CVI) and derived reference change values (RCV) estimated in HD patients were significantly higher than in healthy individuals for calcium (CVI =3.8% vs. 2.3%) (RCV =12.6% vs. 7.6%), inorganic phosphorus (13.1% vs. 8.0%) (RCV =38.7% vs. 30.1%) and PTHi (20.3% vs. 11.3%) (RCV =57.5% vs. 34.0%). For calcium, inorganic phosphorus and PTHi, RCV derived from advanced disease-specific BV data is recommended for the management of bone-mineral disturbances in HD patients. For the rest of cardiovascular risk factors, the use of RCV derived from healthy individuals could be appropriate.


Lithium and memantine improve spatial memory impairment and neuroinflammation induced by β-amyloid 1-42 oligomers in rats.
Alzheimer's disease (AD) is the most common cause of dementia in the elderly. The main hallmarks of this disease include progressive cognitive dysfunction and an accumulation of soluble oligomers of β-amyloid (Aβ) 1-42 peptide. In this research, we show the effects of lithium and memantine on spatial memory and neuroinflammation in an Aβ1-42 oligomers-induced animal model of dementia in rats. Aβ 1-42 oligomers were administered intrahippocampally to male wistar rats to induce dementia. Oral treatments with memantine (5mg/kg), lithium (5mg/kg), or both drugs in combination were performed over a period of 17days. 14days after the administration of the Aβ1-42 oligomers, the radial arm-maze task was performed. At the end of the test period, the animals were euthanized, and the frontal cortex and hippocampus were removed for use in our analysis. Our results showed that alone treatments with lithium or memantine ameliorate the spatial memory damage caused by Aβ1-42. The animals that received combined doses of lithium and memantine showed better cognitive performance in their latency time and total errors to find food when compared to the results from alone treatments. Moreover, in our study, lithium and/or memantine were able to reverse the decreases observed in the levels of interleukin (IL)-4 that were induced by Aβ1-42 in the frontal cortex. In the hippocampus, only memantine and the association of memantine and lithium were able to reverse this effect. Alone doses of lithium and memantine or the association of lithium and memantine caused reductions in the levels of IL-1β in the frontal cortex and hippocampus, and decreased the levels of TNF-α in the hippocampus. Taken together, these data suggest that lithium and memantine might be a potential therapy against cognitive impairment and neuroinflammation induced by Aβ1-42, and their association may be a promising alternative to be investigated in the treatment of AD-like dementia.


The mechanisms involved in the impairment of hematopoiesis after autologous bone marrow transplantation.
Hematopoiesis after autologous bone marrow transplantation (BMT) is characterized by a prolonged and severe deficiency of marrow progenitors for several years, especially of erythroid and megakaryocyte progenitors, while the peripheral blood cells and marrow cellularity have reached relatively normal values within a few weeks. These anomalies are comparable to those reported for allogeneic BMT, despite the absence of any allo-immune reaction or post-graft immunosuppressive therapy. Post-graft hematopoietic impairment is the consequence of quantitative and qualitative changes involving both stem cell and stromal compartments which are expressed by an impaired capacity of stem cell self-renewal and commitment towards erythroid and megakaryocytic lineages. Besides the toxicity of conditioning regimens, hematopoietic reconstitution using autologous grafts is particularly dependent on a combination of factors related to the patient, such as underlying disease and pre-graft chemotherapy regimens, and to the graft processing itself, such as in vitro purging with chemotherapeutic agents.


Intrathecal pethidine as sole anaesthetic agent for operative procedures of the lower limb, inguinal area and perineum.
Intrathecal pethidine as a sole anaesthetic agent for surgical procedures of the lower limbs, perineum and inguinal areas was investigated and compared with hyperbaric Bupivacaine. A total of 90 patients were studied and randomly divided into groups 1 (bupivacaine) and 2 (pethidine). In group 2, 26 of 46 patients (59%) had their procedures successfully with intrathecal pethidine alone and did not require or request any additional sedation or analgesia. This compared to 24 of 44 patients (52.2%) in the bupivacaine group. Pethidine had a prolonged postoperative analgesia and was more cost-effective. The incidences of side effects were acceptable. (hypotension 13.6%, bradycardia 9.09%, nausea and vomiting 11.4%, and pruritus 15.9%). Pethidine can be used as a sole anaesthetic agent for operative procedures of the lower limbs; side effects are mild and can be treated.


[A Case of Septic Shock Immediately following Cesarean Section].
Here we report a case of severe septic shock immediately following cesarean section. A pregnant woman with dichorionic diamniotic twins was diagnosed with preterm rupture of membranes (PROM). Ritodrine hydrochloride and betamethasone did not sufficiently relieve abdominal extension; emergency cesarean section was scheduled 4 days later, at 31 week 5 day gestation. The patient did not show any symptoms or laboratory data suggesting infection. Spinal anesthesia was initiated with 2.2 ml of 0.5% bupivacaine hydrochloride and fentanyl 10 μg at L3-4; sensory loss (T3) was confirmed. Epidural anesthesia at L1-2 was performed for postoperative pain control. Surgery proceeded uneventfully, but the first baby did not respond to neonatal CPR. One hour after surgery, the patient showed signs of shock and a fever of 40.9 degrees C. Catecholamine and antibiotics relieved her symptoms. Retrograde infection of Escherichia coli was attributed to fetal distress and septic shock. Early phase septic shock should be considered in pregnant women with PROM.


Proton Shuttling and Reaction Paths in Dissociative Electron Attachment to o- and p-Tetrafluorohydroquinone, an Experimental and Theoretical Study.
Here we present a combined experimental and theoretical study on the fragmentation of o- and p-tetrafluorohydroquinone upon low energy electron attachment. Despite an identical ring-skeleton and identical functional groups in these constitutional isomers, they show distinctly different fragmentation patterns, a phenomenon that cannot be explained by distinct resonances or different thermochemistry. Using high-level quantum chemical calculations with the computationally affordable domain localized pair natural orbital approach, DLPNO-CCSD(T), we are able to provide a complete and accurate description of the respective reaction dynamics, revealing proton shuttling and transition states for competing channels as the explanation for the different behavior of these isomers. The results represent a "schoolbook example" of how the combination of experiment and modern high-level theory may today provide a thorough understanding of complex reaction dynamics by computationally affordable means.


Metastases to the adrenal glands and the development of Addison's disease.
Metastases to the adrenal glands are common in patients with cancer but symptomatic Addison's disease is rarely noted in this population. The development of body computerized tomography (CT) allows the diagnosis of adrenal metastases to be made more readily antemortem. From 1980 to 1981, 19% (4/21) of patients at the Massachusetts General Hospital who had metastatic cancer and who were noted to have enlarged adrenal glands on CT also had or developed symptomatic adrenal insufficiency. The case histories of 8 patients with Addison's disease and one patient with adrenal hemorrhage on the basis of metastatic infiltration are reviewed. Since adrenal insufficiency may develop abruptly in this group of patients, it is suggested that prophylactic maintenance glucocorticoid therapy be initiated as soon as the diagnosis of adrenal metastases is made.


Electrochemical measurement of mercury concentration profiles in the pore-waters of sediments of the Venice Lagoon by ion-exchange voltammetry at polymer modified electrodes.
Glassy carbon electrodes modified with coatings of poly-[1-methyl-3-(pyrrol-1-ylmethyl)pyridinium], poly-MPP, were employed for preconcentrating and detecting the anionic complex HgCl4(2-), which is the prevailing inorganic Hg(II) species in salt waters such as the pore-waters of sediments here examined. The application of ion-exchange voltammetry at poly-MPP coated electrodes in combination with an in situ pore-water sampler allowed the measurement of concentration vs. depth profiles for mercury dissolved in the pore-waters of a salt-marsh and of a mud-flat located in a polluted area of the Venice Lagoon. The trends of the mercury profiles are discussed in comparison with the trends measured from the same location for other trace metals (Zn, Cd, Cu and Pb) and reduced species such as S(-II) and Fe(II).


A vacuum ultraviolet laser pulsed field ionization-photoion study of methane (CH4): determination of the appearance energy of methylium from methane with unprecedented precision and the resulting impact on the bond dissociation energies of CH4 and CH4.
We report on the successful implementation of a high-resolution vacuum ultraviolet (VUV) laser pulsed field ionization-photoion (PFI-PI) detection method for the study of unimolecular dissociation of quantum-state- or energy-selected molecular ions. As a test case, we have determined the 0 K appearance energy (AE0) for the formation of methylium, CH3+, from methane, CH4, as AE0(CH3+/CH4) = 14.32271 ± 0.00013 eV. This value has a significantly smaller error limit, but is otherwise consistent with previous laboratory and/or synchrotron-based studies of this dissociative photoionization onset. Furthermore, the sum of the VUV laser PFI-PI spectra obtained for the parent CH4+ ion and the fragment CH3+ ions of methane is found to agree with the earlier VUV pulsed field ionization-photoelectron (VUV-PFI-PE) spectrum of methane, providing unambiguous validation of the previous interpretation that the sharp VUV-PFI-PE step observed at the AE0(CH3+/CH4) threshold ensues because of higher PFI detection efficiency for fragment CH3+ than for parent CH4+. This, in turn, is a consequence of the underlying high-n Rydberg dissociation mechanism for the dissociative photoionization of CH4, which was proposed in previous synchrotron-based VUV-PFI-PE and VUV-PFI-PEPICO studies of CH4. The present highly accurate 0 K dissociative ionization threshold for CH4 can be utilized to derive accurate values for the bond dissociation energies of methane and methane cation. For methane, the straightforward application of sequential thermochemistry via the positive ion cycle leads to some ambiguity because of two competing VUV-PFI-PE literature values for the ionization energy of methyl radical. The ambiguity is successfully resolved by applying the Active Thermochemical Tables (ATcT) approach, resulting in D0(H-CH3) = 432.463 ± 0.027 kJ mol-1 and D0(H-CH3+) = 164.701 ± 0.038 kJ mol-1.


SARS-CoV nucleocapsid protein binds to hUbc9, a ubiquitin conjugating enzyme of the sumoylation system.
SARS-CoV is a newly identified coronavirus (CoV) that causes severe acute respiratory syndrome (SARS). The SARS-CoV nucleocapsid (N) protein is an important structural and functional protein. To identify cellular proteins that interact with the SARS-CoV N protein and to elucidate the possible involvement of N protein in SARS-CoV pathogenesis, a human lymphocyte cDNA library was screened using a yeast two-hybrid system assay. hUbc9, a ubiquitin conjugating enzyme of sumoylation system, was found to interact specifically with the N protein, implying the post-translational sumoylation of the N protein. Mapping studies localized the critical N sequences for this interaction to amino acids 170-210, which includes the SR-rich motif. However, the consensus motif of sumoylation GK(62)EE in the N protein is not responsible for binding to hUbc9. Mutations of hUbc9 at the enzyme active site C93A or C93S severely impair the interaction with the N protein. The two proteins were also shown to colocalize in the cytoplasm of the transfected 293T cells. This is the first report demonstrating the interaction of hUbc9 with a structural protein of plus-strand RNA viruses, indicating a new drug target for SARS-CoV.


Feasibility and Acceptability of the Modified Antiretroviral Treatment Access Study (MARTAS) Intervention Based on a Pilot Study in Ukraine.
We conducted a pilot of the Modified Antiretroviral Treatment Access Study (MARTAS), a linkage to HIV treatment intervention, prior to implementing a multisite randomized controlled trial (RCT) in Ukraine. The objectives of the pilot were to assess the feasibility and acceptability of the MARTAS intervention among a small sample of adults recently diagnosed with HIV at specialty clinics in the Mykolaiv region of Ukraine in 2015. The adapted intervention consisted of up to 6 individual-level sessions with a linkage coordinator (nurse) over a 90-day period. Overall, 22 persons participated in the pilot. On average, participants received 4.2 sessions and 14 participants linked to HIV care within 3 months of study enrollment. All 18 participants who completed the acceptability survey expressed high satisfaction with their interaction with their linkage coordinator. The results of the pilot demonstrated feasibility and acceptability of the MARTAS intervention in advance of a larger scale RCT in Ukraine.


Toward a selective, sensitive, fast-responsive, and biocompatible two-photon probe for hydrogen sulfide in live cells.
Hydrogen sulfide has emerged as an exciting endogenous gasotransmitter in addition to nitric oxide and carbon dioxide. Noninvasive detection methods for hydrogen sulfide thus become indispensable tools for studying its diverse roles in biological systems. Accordingly, fluorescent probes for hydrogen sulfide have received great attention in recent years. A practically useful fluorescent probe for bioimaging of hydrogen sulfide should be selective, sensitive, fast-responsive, biocompatible, observable in the biological optical window, and capable of deep-tissue imaging. These sensing properties, however, are extremely difficult to achieve at the same time. Disclosed here is the two-photon fluorescent probe that meets all of these criteria. The probe belongs to a Michael acceptor system, which raised a serious selectivity issue over the competing biothiols such as cysteine and glutathione. We have addressed the selectivity issue by optimizing the electronic and steric interactions between biothiols and the probe, in addition to achieving very high sensitivity, fast-response, and biocompatibility. Also, the sensing mechanism suggested in the literature was revised. The probe thus enables us to image the endogenously produced hydrogen sulfide with negligible interference from other biothiols in live cells. The excellent sensing properties of the probe combined with its capability of bioimaging thus make it a practically useful tool for further studying biological roles of hydrogen sulfide.


Behavioral effects of original tetrapeptide, an analog of N-terminal nociceptin fragment.
The study examined the effect of an analog to N-terminal nociceptin fragment AcOH×Phe-Gly-Gly-Phe-NH(2) on the behavior of albino rats. This tetrapeptide (5 μg/kg intraperitoneally) significantly enhanced motor and exploratory activity in mature rats and in 42-day pups and produced opposite effects in 21-day rat pups, which attests to the complex dynamics of maturation of nervous structures involved in the realization of nociceptin action.


A colorimetric nanosensor based on a selective target-responsive aptamer kissing complex.
Herein, we report a novel approach for the design of a colorimetric aptasensor based on functionalized gold nanoparticle probes. This approach relies on the conjugation of nanoparticles by two functional DNA and RNA hairpins that engage specific kissing (loop-loop) interactions in response to the addition of a small analyte ligand, leading to particle aggregation and then red-to-purple colour change of the colloidal solution.


An E-Learning Program for Continuing Midwifery Education on Handling High-Risk Abuse Cases: A Pretest-Posttest Design.
It is essential to equip midwives and nurses working in the perinatal period with comprehensive knowledge and awareness regarding child abuse prevention. However, most midwives and nurses in Japan do not have the opportunity to learn about abuse prevention during their basic education. We aimed to develop an e-learning program to assist obstetric midwives and nurses in acquiring the knowledge needed to provide support and handle cases with a high risk of abuse, as well as to assess the program's usefulness. This study employed a single-group pre-post design; e-learning served as the intervention. Seventy-one obstetric midwives and nurses were recruited. The program's usefulness was the difference between the participants' pretest and post-test knowledge and efficacy scores. The score data were analyzed using the t-test. A paired t-test revealed that the post-test scores of knowledge and efficacy were significantly higher than those of the pretest, with a large effect size (d = 1.71). Platforms where basic knowledge on how to respond to high-risk abuse cases are lacking in nursing education; thus, this e-learning program is recommended for nurses working in the perinatal field throughout Japan. This educational opportunity for perinatal midwives and nurses will increase awareness and contribute to abuse prevention.


Physical examination of the knee.
Even with the rapid advancement in technology and medical imaging, there is still no substitute for the history and physical examination that can be obtained from a patient. With a well-performed history and physical, the majority of pathology can be determined prior to any expensive imaging or surgical procedures. The knee is one of the most commonly injured joints, and its function is critical to basic ambulation and participation in sports, work, and activities of daily living. This article reviews the key concepts to a complete evaluation of the knee and highlights aspects of the physical examination and radiographic imaging that best aid in diagnosing knee pathology.


RAST studies : IgE antibodies to Dermatogoides pteronyssinus (house dust mite), Aspergillus fumigatus and beta-lactoglobulin in sudden death in infancy syndrome (SDIS).
The incidence of 2.5 SDIS cases per 1,000 live births found in Western Australia is in agreement with figures reported for other centres. While the age range of SDIS victims extended from two weeks to 15 months, 57 per cent of deaths occurred in children of two to four months of age. Boys outnumbered girls 1.6:1. Environmental factors are implicated in that the majority of deaths occurred in a biphasic distribution - autumn and late winter months. No significant differences were observed in total IgE levels in serum from SDIS victims, post mortem children who died in trauma of known aetiology and live control children of the same age range. Serum IgE antibodies to D.pteronyssinus were found in 37% of SDIS victims compared with 7% of matched controls (post mortem plus live groups). IgE antibodies to beta-lactoglobulin, the major allergen of cow's milk, appeared with twice the frequency in SDIS vs. control group but both groups showed a similar incidence of antibodies to the allergens of Aspergillus fumigatus. The prevalence of IgE antibodies to D.pteronyssinus in SDIS victims who died in the late winter -- early spring period was double that found in the group who died in the autumn period. Sixtyfour percent of the SDIS victims had antibodies to two or more of the three allergens tested while the control sera were positive to only one allergen. These results support the hypothesis that anaphylaxis induced by immediate hypersensitivity to D.pteronyssinus in particular may be one of the causative factors in SDIS in Western Australia.


Photoluminescence response of terbium-exchanged MFI-type materials to Si/Al ratio, texture, and hydration state.
Terbium-exchanged MFI zeolite type materials, i.e., microporous-mesoporous Zeotile-1 with the Si/Al ratio in the range 33-200, Zeogrid with the Si/Al ratio of 75, and nanocrystalline MFI with the Si/Al ratio of 75, were prepared via an ion exchange procedure. All of these zeolites were investigated by means of time-resolved photoluminescence techniques in various hydration states: as-synthesized (hydrated), calcined (heated at 450 degrees C in air), and rehydrated (after a six-month exposure to the atmospheric moisture). The photoluminescence decays and spectra were analyzed by discrete exponential fitting, distribution lifetimes analysis, and area-normalized time-resolved photoluminescence spectra. The results sustained a single average terbium species coordinated to both water molecules and framework oxygens in the hydrated zeolites. The framework contribution increased with the Si/Al ratio in Zeotile-1 and was greatest for the nanocrystalline MFI zeolite. For the calcined Zeotile-1 and Zeogrid, two main terbium species of different environments were found. For the nanocrystalline Tb3+-MFI, a distinct number of species could not be inferred, indicating a more heterogeneous distribution. Rehydration further differentiated among the Tb3+-exchanged zeolites. Photoluminescence line shape and decay of Tb3+-Zeotile-1 were between those of the hydrated and calcined states indicating a slow rehydration rate in contrast with the photoluminescence properties of Tb3+-MFI, which fully recovered the values of the hydrated state. Tb3+-Zeogrid presented an intermediate case: while the PL line shape was fully restored to that measured for the hydrated sample, the decay was still longer than that measured with the hydrated sample. Terbium photoluminescence response related to zeolite texture, Si/Al ratio, and hydration state suggest different sitting and location of terbium in Zeotile-1, Zeogrid, and nanocrystalline MFI materials. In mesoporous Zeotile-1 and Zeogrid, the results sustained two types of terbium sites: one on the internal surface of mesopores, the other inside the pores, while for the nanocrystalline MFI, terbium sites inside the pores predominate.


Vibrational spectroscopy of CO in gas-phase rhodium cluster-CO complexes.
Infrared spectra of isolated unsaturated rhodium cluster-CO complexes in the region of the CO stretching vibration, nu(CO), are measured using a molecular beam depletion technique. These spectra provide benchmarks for interpreting values of nu(CO) that are found when CO is used to probe Rh surfaces and supported Rh nanoparticles. Supported nanoparticles have shifts of nu(CO) of as much as +100 cm-1 compared to the free clusters measured here, indicative of significant charge transfer to the support.


Left atrial size and risk of major cardiovascular events during antihypertensive treatment: losartan intervention for endpoint reduction in hypertension trial.
The influence of left atrial size on cardiovascular events during antihypertensive treatment has not been reported previously from a long-term, prospective, randomized hypertension treatment trial. We recorded left atrial diameter by annual echocardiography and cardiovascular events in 881 hypertensive patients (41% women) with electrocardiographic left ventricular hypertrophy aged 55 to 80 (mean: 66) years during a mean of 4.8 years of randomized losartan- or atenolol-based treatment in the Losartan Intervention for Endpoint Reduction in Hypertension Study. During follow-up, a total of 88 primary end points (combined cardiovascular death, myocardial infarction, or stroke) occurred. In Cox regression, baseline left atrial diameter/height predicted incidence of cardiovascular events (hazard ratio: 1.98 per cm/m [95% CI: 1.02 to 3.83 per cm/m]; P=0.042) adjusted for significant effects of Framingham risk score and history of atrial fibrillation. Greater left atrial diameter reduction during follow-up was associated with greater reduction in left ventricular hypertrophy, absence of new-onset atrial fibrillation or mitral regurgitation during follow-up, and losartan-based treatment (B=-0.13+/-0.03 cm/m; P<0.001) in multiple linear regression, adjusting for baseline left atrial diameter/height. However, in time-varying Cox regression analysis, left atrial diameter reduction was not independent of left ventricular hypertrophy regression in predicting cardiovascular events during follow-up. In conclusion, left atrial diameter/height predicts risk of cardiovascular events independent of other clinical risk factors in hypertensive patients with left ventricular hypertrophy and may be useful in pretreatment clinical assessment of cardiovascular risk in these patients.


Inhalation toxicology.
Inhalation of gases, vapors and aerosols can cause a wide range of adverse health effects, ranging from simple irritation to systemic diseases. The large number of chemicals and complex mixtures present in indoor and outdoor air coupled with the introduction of new materials such as nanoparticles and nanofibers, is an area of growing concern for human health. Animal-based assays have been used to study the toxic effects of chemicals for many years. However, even so, very little is known about the potential toxicity of the vast majority of inhaled chemicals. As well as new or refined OECD test guidelines, continuing scientific developments are needed to improve the process of safety evaluation for the vast number of chemicals and inhaled materials. Although studying the toxic effects of inhaled chemicals is more challenging, promising in vitro exposure techniques have been recently developed that offer new possibilities to test biological activities of inhaled chemicals under biphasic conditions at the air liquid interface. This chapter gives an overview of inhalation toxicology as well as focusing on the potential application of in vitro methods for toxicity testing of airborne pollutants.


Disposition and metabolism of metronidazole in patients with liver failure.
A pharmacokinetic study of metronidazole disposition was performed in 10 patients with severe liver disease, the majority of whom also had impaired renal function. Following a single intravenous dose, systemic clearance of metronidazole was decreased by 66% in patients compared with healthy controls (p less than 0.001). The apparent volume of distribution for metronidazole was also decreased in patients (by 21%), but the greater effect on clearance resulted in the elimination half-life being prolonged 152%. Total urinary excretion of unaltered metronidazole was not reduced in patients compared with controls, and systemic clearance of metronidazole did not correlate with creatinine clearance. Hepatic production of hydroxymetronidazole [1-(2-hydroxyethyl)-2-hydroxymethyl-5-nitroimidazole], the major oxidative metabolite of metronidazole, was significantly lowered in patients with liver failure. Peak plasma levels of this metabolite were lower, the time taken to achieve peak levels was longer and the area under the plasma concentration approximately time curve (AUC0-25h) was reduced in patients compared to controls (p less than 0.05). Similarly, urinary recovery of hydroxymetronidazole was lower in patients with liver disease while excretion of the other major oxymetabolite, 1-acetic acid-2-methyl-5-nitroimidazole, appeared reduced to an even greater extent. Thus, while the presence of renal function impairment in a patient with cirrhosis indicates that metronidazole elimination is likely to be abnormal, the principal mechanism for delayed elimination is impaired hepatic drug metabolism rather than reduced renal clearance of metronidazole and its major metabolites.


Spousal support in diabetes self-management among Korean immigrant older adults.
The authors of the current article investigated domains of spousal support among diabetic Korean older adults and their spouses. Two focus groups were conducted with diabetic participants from the greater Los Angeles Korean community, and three were conducted with their spouses. In the focus groups, participants were asked to describe the spousal support given or received for diabetes self-management. Each group comprised four to nine participants. Focus groups were audiotaped, transcribed, and translated; two independent coders identified domains of spousal support. Content analysis identified six domains: diet, exercise, emotional support, medical regimen, communication with clinicians, and information. Diet was the most frequently described domain across all groups. Gender differences were noted in domains of information, communication, and medical regimen among diabetic participants. Both diabetic and spouse participants identified individualizing spousal support and recognizing diabetes management as teamwork as important elements of successful spousal support. Spousal support education for Korean older adults may have the greatest impact by incorporating these six domains, addressing gender differences, providing tips on individualizing support, and cultivating teamwork.


The frequency of Leu 1+B cells in autoantibody positive and negative autoimmune diseases and in neonatal cord blood.
There is increasing evidence supporting the involvement of Leu 1+B cells in the development of human autoimmune diseases. In this study, the frequency of Leu 1+B cells has been analysed by a multiparameter FACS machine in newborn cord blood, and in the peripheral blood of several autoimmune patients and their healthy adult controls. Higher frequencies were observed in systemic lupus erythematosus (SLE), in seropositive rheumatoid arthritis (RA) and in newborn cord blood compared to control adults and seronegative RA. No relationship was observed between the frequency of Leu 1+B cells, and the age, sex and medication of the subjects.


Transvascular therapy of Hepatocellular Carcinoma (HCC), status and developments.
Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide. Only 30-40% of patients diagnosed with HCC are candidates for curative treatment options. The remaining majority of patients undergo local, regional or systemic palliative therapies. Transvascular therapy of HCC takes advantage of the fact that hypervascularized HCCs receive their main perfusion from the hepatic artery. In this context transvascular therapy describes different therapies: bland embolization (transarterial embolization, TAE), cTACE (conventional transarterial chemoembolization), DEB-TACE (TACE with drug-eluting beads, DEB) and SIRT (selective internal radiation therapy, radioembolization). cTACE is the most common type of transvascular treatment and represents a combination of the intra-arterial use of a chemotherapeutic agent and embolization. There is no standardized regimen for cTACE. It remains unclear whether the intra-arterial application of a chemotherapeutic agent is definitely required, because bland embolization alone using very small spherical particles shows tumor necrosis comparable to cTACE. For DEB-TACE microparticles loaded with a chemotherapeutic drug combine the advantages of cTACE and bland embolization.


Conversion from external fixation to definitive fixation: periarticular injuries.
Extremity injuries sustained by uniformed service combatants pose a significant challenge to military orthopaedic surgeons. The wounding mechanisms in Operation Iraqi Freedom and Operation Enduring Freedom consist of blasts, penetrating injuries, and blunt injuries. The mortality of warriors has decreased overall because of the improvements in head, neck, and torso body armor. Consequently, the severity of extremity wounds has increased. Because of the far-forward surgical assets (surgeons and advanced equipment), these patients are stabilized rapidly and their injured extremities are treated early (ie, revascularized, débrided, stabilized). However, multiple challenges exist in the timing of definitive reconstructive efforts once these injured service members return to military medical centers in the continental United States.


Controlled cyclosporine conversion at three months after renal transplantation. Long-term results.
The long-term results of conversion of cyclosporine to azathioprine and those of continuous CsA therapy were evaluated in a prospective study of 66 renal transplant patients who had been randomly assigned to each treatment group at 3 months following transplantation. The start point of the study was thus at 3 months posttransplant; no differences in the three-year patient and graft survival were found; these consisted of 97% and 94% in the converted group and 100% and 94% in the nonconverted group, respectively. The incidence of one or more antirejection treatments did not differ between the two groups at 3-12 months (16% vs. 17%) or after 12 months (12% vs. 9%). The incidence of hypertension at different intervals ranged from 79% to 100% in the group on continuous CsA therapy versus 50 to 58% in the converted patients. The degree of proteinuria in the 2 groups was not different at at 12 months. At 24 and 36 months the proteinuria (g/24 hr) was higher in the converted group (0.51 +/- 0.18 and 0.53 +/- 0.13; mean +/- SEM) versus the CsA group (0.15 +/- 0.04 and 0.21 +/- 0.09). At 3 years, the mean creatinine clearance for the patients converted to Aza was higher than that found for the continuously CsA-treated patients (67 +/- 8 and 59 +/- 6 ml/min; mean +/- SEM). This study shows that early CsA conversion to Aza gives a slightly better 3-year graft function, although not significantly different, compared with continuous CsA therapy without differences in patient or graft survival.


Activation of inwardly rectifying K+ channels by GABA-B receptors expressed in Xenopus oocytes.
In Xenopus oocytes coinjected with poly(A)+ RNA derived from the rat cerebellum and cRNAs for the cloned G protein-gated inwardly rectifying K+ channel (GIRK), GIRK1 and GIRK2, the GABA-B agonist baclofen elicited inwardly rectifying K+ currents. The inward K+ currents elicited by baclofen were inhibited by the selective GABA-B antagonists 2-OH saclofen and CGP 35348, and by the GIRK inhibitor Ba2+. In contrast, baclofen caused no currents in oocytes injected with the cerebellar poly(A)+ RNA alone, the poly(A)+ RNA and cRNA for GIRK1 or GIRK2, or only cRNAs for GIRK1 and GIRK2. These findings indicate that GABA-B receptors in the rat cerebellum were functionally expressed in Xenopus oocytes and activated the cloned GIRKs composed of GIRK1 and GIRK2 as heteromultimers.


Artificial neural network as a tool to compensate for scatter and attenuation in radionuclide imaging.
This study investigates the ability of artificial neural networks (ANN) to simultaneously correct for attenuation and Compton scattering in scintigraphic imaging. Three sets of experiments are conducted using images of radioactive sources with various shapes and distributions in a homogeneous medium. Numerical Monte Carlo simulations and physical phantom acquisitions of radioactive geometric sources provide the basic material for correction. Our method is based on the following assumptions: information needed to correct for scattering can be extracted from the energy spectrum at each pixel without any assumption concerning the source distribution, and two diametrically opposed energy spectrum acquisitions yield enough information on the source location in the diffusing medium for simultaneous correction for attenuation and scattering. Qualitative and quantitative evaluations of scatter correction by ANN demonstrate its ability to perform scatter correction from the energy spectra observed in each pixel. By using the energy spectra of incident photons detected in two diametrically opposed images, multilayer neural networks are able to perform a proper restitution of projection images without any assumption on geometry or position of radioactive sources in simple geometric cases. ANN corrections compare favorably to those provided by five of the most popular methods. A satisfying correction of both scatter and attenuation is observed for a human pelvis scan obtained during routine clinical practice. An ANN is an efficient tool for attenuation and Compton scattering in simple model cases. The results obtained for routine scintigrams in a much more complex situation are strong incentives for performing further studies.


Enzyme system of Clostridium stercorarium for hydrolysis of arabinoxylan: reconstitution of the in vivo system from recombinant enzymes.
Four extracellular enzymes of the thermophilic bacterium Clostridium stercorarium are involved in the depolymerization of de-esterified arabinoxylan: Xyn11A, Xyn10C, Bxl3B, and Arf51B. They were identified in a collection of eight clones producing enzymes hydrolysing xylan (xynA, xynB, xynC), beta-xyloside (bxlA, bxlB, bglZ) and alpha-arabinofuranoside (arfA, arfB). The modular enzymes Xyn11A and Xyn10C represent the major xylanases in the culture supernatant of C. stercorarium. Both hydrolyse arabinoxylan in an endo-type mode, but differ in the pattern of the oligosaccharides produced. Of the glycosidases, Bxl3B degrades xylobiose and xylooligosaccharides to xylose, and Arf51B is able to release arabinose residues from de-esterified arabinoxylan and from the oligosaccharides generated. The other glycosidases either did not attack or only marginally attacked these oligosaccharides. Significantly more xylanase and xylosidase activity was produced during growth on xylose and xylan. This is believed to be the first time that, in a single thermophilic micro-organism, the complete set of enzymes (as well as the respective genes) to completely hydrolyse de-esterified arabinoxylan to its monomeric sugar constituents, xylose and arabinose, has been identified and the enzymes produced in vivo. The active enzyme system was reconstituted in vitro from recombinant enzymes.